For your reference, the sections of the application and their requirements are listed below.

Section 1: Application Cover Page

(The cover page should list only current information and is limited to 1 page.)

Name:

Faculty Rank:

School/College:

Department:

Clinical Responsibilities and Location:

Years at AMC or other academic medical/healthcare institution:

​Section 2:Application Responses

(Limit your response to 1 page for each of the items #1-4 below. Longer responses will not be considered.)

What (if any) previous education or training (resulting in a degree, certificate, or other recognition) have you had in teaching, educational scholarship, or leadership? Name and briefly describe the program.

What personal/professional goals do you expect to achieve through participation in TSP?

Briefly describe an idea you have for a medical/healthcare education research project or a curriculum development project and what your role would be in the project.

Explain/Describe how your project idea (described in #3) was generated. Include information on any funding or support you have and what major obstacles you anticipate in development and implementation of the idea. Indicate if you have an identified mentor for this project (provide their name and contact information) and what your relationship is with this person. Note that having an identified mentor prior to entry is not required, and we will gladly work with you to identify an appropriate project and/ or career mentor.

Section 3: Letter of Commitment from Applicant’s Supervisor

[insert date]

As the Department Chair/Division Head in [insert name of department or program], and the supervisor for [insert name of TSP applicant], I understand that the Teaching Scholars Program is a selective faculty development opportunity to enhance knowledge and skills and develop future leaders in medical/healthcare education with a focus on educational scholarship and curriculum development. This 18 month certificate program culminates in the development of an education research project or a curriculum development project.

The program consists of 3 core elements:

Afternoon Seminar Series over the academic year (meeting approximately 2 times a month)

Curriculum Development Project and/or Education Scholarship Project

Faculty Mentorship and Guidance

I agree to commit .10 (10%) FTE of [insert name of TSP applicant]’s time from September 10, 2018 through February 14, 2020 to their participation in the Teaching Scholars Program. This commitment includes an understanding and agreement that during this time period, [insert name of TSP applicant] will not be available to our department/program for any clinical services, meetings, or other regularly scheduled activities. I understand that there may be a need for [insert name of TSP applicant] to be available at other days/times on occasion for additional learning opportunities through TSP and the Academy of Medical Educators. I will facilitate [insert name of TSP applicant]’s involvement in these opportunities as much as possible, and I will offer guidance and support for their work directly or indirectly throughout this experience.

I understand that [insert name of TSP applicant] will be informed of their selection for TSP on, or about, April 17, 2018 for the program beginning September 2018 and culminating in February 2020.

Sincerely,
[insert signature]

[Name of Department Chair/Division Head]
[Name of Department or Division]
[Name of School/College]

Submitting your Application

The application deadline is March 19, 2018, close of business, for entry into the cohort starting in September 2018.

Incomplete or late applications will not be considered.

Notification of acceptance will go out no later than April 17, 2018. Successful applicants will be required to respond to the acceptance letter, stating they agree to the attendance and project requirements for TSP.